Clinical Indications for and Outcomes of Reoperation in Adult Tetralogy of Fallot Patients in Japan: A Nationwide Retrospective Study-Reference-Cited by-同舟云学术

Clinical Indications for and Outcomes of Reoperation in Adult Tetralogy of Fallot Patients in Japan: A Nationwide Retrospective Study

Published:2024-08-22 Issue: Volume:3 Page:
ISSN:2754-0650
Container-title:Journal of Asian Pacific Society of Cardiology
language:en
Short-container-title:J Asian Pac Soc Cardiol

Author:

Mizuno Atsushi¹^ORCID,Ueno Takayoshi²^ORCID,Tateno Shigeru³^ORCID,Inai Kei⁴^ORCID,Adachi Osamu⁵^ORCID,Yamamura Kenichiro⁶^ORCID,Yamazawa Hirokuni⁷,Koide Masaaki⁸,Waki Kenji⁹,Ichikawa Hajime¹⁰^ORCID,Matsuo Kozo¹¹^ORCID,Shiraishi Isao¹²^ORCID,Niwa Koichiro¹³^ORCID,

Affiliation:

1. Department of Cardiology, St Luke’s International Hospital, Tokyo, Japan; Department of Cardiology, Juntendo University Hospital, Tokyo, Japan

2. Department of Cardiovascular Surgery, Osaka University Graduate School of Medicine, Osaka, Japan

3. Department of Adult Congenital Heart Disease and Pediatric Cardiology, Chiba Cardiovascular Center, Chiba, Japan

4. Department of Pediatric Cardiology and Adult Congenital Cardiology, Tokyo Women’s Medical University, Tokyo, Japan

5. Division of Cardiovascular Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan

6. Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan

7. Department of Pediatrics, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan

8. Department of Cardiovascular Surgery, Seirei Hamamatsu General Hospital, Hamamatsu, Japan

9. Department of Pediatrics, Kurashiki Central Hospital, Okayama, Japan

10. Department of Cardiovascular Surgery, Japan Community Healthcare Organization Osaka Hospital, Osaka, Japan

11. Department of Cardiovascular Surgery, Chiba Cardiovascular Center, Chiba, Japan

12. Department of Pediatric Cardiology, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan

13. Department of Cardiology, St Luke’s International Hospital, Tokyo, Japan

Abstract

Background: Reoperation significantly improves outcomes in tetralogy of Fallot (TOF) patients. However, it is challenging to determine the timing for surgery, especially with complex indications, such as pulmonary regurgitation (PR) with right ventricular outflow tract stenosis or tricuspid regurgitation. Methods: This retrospective study analysed adult TOF patients who underwent reoperation at specialised centres between 2000 and 2015. Exclusions included pulmonary atresia with ventricular septal defect repaired by an extracardiac conduit, double-outlet right ventricle with subaortic ventricular septal defect and pulmonary stenosis and pulmonary atresia. Surgeons determined the primary reoperation indication. Results: Of 154 patients (59.1% male, mean age 35.2 ± 12.0 years), from 10 hospitals, eight deaths (5.2%) occurred over 5.7 years (range 2.5–8.0 years) post-reoperation. The main indications for reoperation were PR, right ventricular outflow tract stenosis, and tricuspid regurgitation (62.3%, 24.0% and 18.2%, respectively). Patients with PR showed more variability in preoperative right ventricular end-diastolic volume index values, particularly without concurrent indications. Conclusion: This study sheds light on reoperation outcomes in Japanese TOF patients before percutaneous treatment availability. Surgical decisions, especially with concurrent indications, need adaptable approaches. Despite the absence of a consensus on preoperative evaluation and thresholds for reoperation, our findings may support current surgical decision-making.

Publisher

Radcliffe Media Media Ltd

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